Investigation Advisor - Group Insurance

Industrial Alliance Insurance and Financial Services Inc; Montreal (administrative region); Hybrid; CAD 70,000 - 100,000; Full time

Benefits offered by this job

Competitive benefits

Pension plan

Stock purchase plan

Wellness/personal development days

Telemedicine

Employee assistance program

Ergonomic furniture program

Job summary

Industrial Alliance Insurance and Financial Services Inc. seeks an Investigation Advisor for Group Insurance to lead fraud prevention and investigations across Canada. You will review referrals, analyze alerts, and gather evidence from multiple sources while maintaining objectivity and professional judgment.

You will document findings, propose recommendations, and collaborate with analytics teams to enhance detection rules. Strong communication in French and English is essential in this role.

Qualifications

• 3–5 years of experience in auditing, investigations, insurance, healthcare, or financial services.
• Proficient in data analysis and interpretation, with the ability to review large volumes of transactional data while maintaining confidentiality.
• Fully proficient in French and advanced English for cross-Canada communication.

Responsibilities

• Review referrals and information on suspected fraud or abuse related to health and dental claims.
• Analyze alerts from fraud detection tools and conduct independent data analysis to identify suspicious patterns.
• Conduct thorough investigations, gather evidence from members, providers, and internal systems.
• Document findings, develop recommendations, and prepare client reports.
• Collaborate with analytics teams to improve alert quality and detection rules.
• Contribute to continuous improvement of investigation processes and tools.
• Manage escalated cases with professionalism and follow up.
• Promote fraud prevention through awareness and strategic recommendations.
• Stay current on emerging fraud trends and best practices.

Skills

Analytical thinking

Critical thinking

Data analysis

Communication

Reporting

Multi-tasking

Bilingual - French/English

Tools

Fraud detection tools

Analytics tools

Job description

Investigation Advisor, Group Insurance

Build the future with us

Are you passionate about investigations and motivated by the opportunity to support an organization whose purpose is to help clients feel confident and secure about their future? As an Investigation Advisor, Group Insurance, you will play a key role in protecting the integrity of our insurance programs.

This position offers an excellent opportunity to showcase your expertise and reach your full potential within a trusted and people-centered organization. Here, individuals and their development are at the heart of everything we do, fostering an environment built on collaboration, innovation, and continuous growth.

What You Will Accomplish With Us

As an Investigation Advisor, Group Insurance, you will be at the center of our fraud prevention and investigation efforts. Your key responsibilities will include:

• Reviewing referrals and information received from internal and external sources regarding suspected fraud or abuse related to health and dental claims.
• Analyzing alerts generated by fraud detection tools and conducting independent data analysis to identify suspicious patterns and potentially fraudulent activity. Prioritizing investigative efforts based on risk level, financial exposure, and expected value.
• Conducting thorough investigations by gathering evidence from plan members, service providers, internal systems, and other relevant sources while maintaining objectivity throughout the process.
• Clearly documenting findings, developing recommendations, and preparing reports for clients.
• Partnering with analytics teams to enhance alert quality and improve the effectiveness of fraud detection mechanisms. Recommending enhancements to detection rules, scenarios, and tool parameters based on investigation outcomes and frontline observations.
• Contributing to the continuous improvement of investigation processes, tools, and practices.
• Managing escalated cases with professionalism and ensuring thorough follow-up.
• Promoting fraud prevention among internal and external stakeholders through awareness initiatives and strategic recommendations.
• Keeping current on emerging fraud trends, schemes, and industry best practices.

What could accelerate your success in this role

We’re looking for someone who:

• Has 3 to 5 years of experience in auditing, investigations, insurance, healthcare, or financial services.
• Is recognized for strong analytical and critical thinking skills, with the ability to navigate uncertainty and exercise sound professional judgment in ambiguous or incomplete situations.
• Demonstrates proficiency in data analysis and interpretation, experience using analytical tools, and the ability to review large volumes of transactional data while exercising discretion and professionalism when handling sensitive information.
• Possesses excellent communication and interpersonal skills, including the ability to manage difficult conversations professionally, along with strong writing skills to produce clear, objective, and well-documented reports.
• Has proven ability to manage multiple investigations simultaneously, adapt to changing priorities in a fast-paced environment, and work both independently and collaboratively with a strong sense of accountability and initiative.
• Is fully proficient in French and has an advanced level of English, as this role requires regular communication with internal and external clients across Canada.

Why you’ll love working with us

• A work environment where learning and development merge with a collective pursuit of excellence;
• A healthy, safe, fair, and inclusive environment where potential can be freely expressed and developed;
• The opportunity to work in a hybrid environment, supported by flexibility and access to inspiring and innovative workspaces;
• Competitive benefits: Flexible group insurance, competitive pension plan, stock purchase plan, vacation and wellness/personal development days, telemedicine, employee and family assistance program, ergonomic furniture program, performance bonus, discounts on iA products, and much more!

At iA, we believe in potential and value diverse experiences.